| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | Presented by |  | | | With Alice Miranda Ollstein and Carmen Paun
| | |  Nursing homes are struggling to comply with the Biden administration's staffing mandate. | David A. Lieb/AP | STAFFING MANDATE ANGST — Several nursing home operators say they’ll have trouble meeting a new staffing mandate because of a massive nursing shortage, POLITICO’s Robert King reports. Yet the Biden administration insists nursing homes shouldn’t fear a new staffing rule, pointing to exemptions and more time to comply. “There is just not a registered nurse to be found,” administrator Paul Treffert, CEO of the 85-bed nonprofit home Sheboygan Senior Community in Wisconsin, told Robert. “Mandate whatever you want, pay whatever you choose, they are just not there.” The scale of the nursing shortage could impact whether the rule achieves its goal of improving quality in the nursing home industry. The mandate calls for nursing homes to have a registered nurse on site 24/7 and sets other staffing ratios based on the home’s population. Facilities can secure exemptions if they can prove to CMS they’re in an area with a shortage. The administration said in a statement that the new exemptions and staggered deadlines help to balance the needs “of nursing home facilities while addressing patient neglect and nursing burnout.” Rural facilities have five years to comply with the mandate compared with urban nursing homes, which have three. A recent analysis from the think tank KFF estimated 1 in 5 homes don’t meet all the requirements. Nursing homes say they can’t find enough nurses to comply with the rule. Some facilities tell Robert they’re already paying high amounts for travel nurses and overtime. “I would be the first in line to welcome a higher staffing ratio,” Bill Pond, administrator for Noble Horizons in Connecticut, said. “However, for me I don’t know how that can come to fruition with the challenge we currently face.” The nursing population shrank by more than 100,000 from 2020 through 2021, according to an analysis published in Health Affairs in 2022. Burnout due to the pandemic was part of the reason. The mandate, finalized last month, faces a federal lawsuit filed in Texas by several industry trade groups and local homes. The state seeks to strike down the rule, and the filing said the state would need 2,579 additional registered nurses as well as 7,887 nursing assistants to comply. The challenge for nursing homes isn’t just a dearth of nurses overall but also the difficulty of convincing available nurses to work in their facilities. “The person that wants to be a registered nurse most likely wants to work in clinical care,” said Treffert. WELCOME TO MONDAY PULSE. POLITICO asked 22 experts to predict what Trump’s conviction will mean for 2024 and beyond. We suggest you take a look. Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.
| | | | A message from the American Health Care Association: America’s seniors need our help – now. The Administration’s federal staffing mandate will force more nursing homes to close and displace hundreds of thousands of residents. Nursing homes need targeted investments, not blanket mandates. Learn more about our workforce solutions. | | | | | | | 
Dr. Anthony Fauci, who will appear before a House panel on the pandemic today, can expect tough questions from both sides of the aisle. | Cliff Owen/AP | COMITY ON COVID COMMITTEE — The House’s investigative panel on Covid-19, which was expected to devolve into partisan infighting over pandemic rules and the lab leak theory, has found a surprising amount of common cause recently. Whether that extends to today’s scheduled hearing with Dr. Anthony Fauci, which will be the pandemic leader’s first public testimony since he left government in 2022, is another matter. Rep. Debbie Dingell (D-Mich.) told Carmen that her goal will be to ensure Fauci gets a fair hearing. The public needs to “understand what Dr. Fauci did, why he did it, the lives that have been saved [and] what can we learn, both good and bad, from what happened.” However, Fauci is sure to take tough questions playing off the bipartisan concern the committee has expressed over whether government-backed scientists were fully transparent about controversial virus research and whether a longtime adviser to Fauci skirted public records requests. On May 1, Democrats sided with the GOP in condemning Peter Daszak, a British zoologist who has received millions in federal research funding, for failing to comply with government rules when he worked with a Chinese lab, which some people believe to be at the center of Covid’s origin. Democrats again joined Republicans recently in blasting Dr. David Morens, an infectious disease expert who advised Fauci for nearly a quarter century, for his cozy rapport with Daszak and his use of Gmail to conduct official business. That was unexpected, given Democrats’ vigorous defense of the public health bureaucracy during the pandemic. “What we all want are facts. There was evidence of things that were not right,” said Dingell, adding that she’d nonetheless try to prevent her GOP colleagues from “doing a character assassination.”
| | | | THE GOLD STANDARD OF HEALTHCARE POLICY REPORTING & INTELLIGENCE: POLITICO has more than 500 journalists delivering unrivaled reporting and illuminating the policy and regulatory landscape for those who need to know what’s next. Throughout the election and the legislative and regulatory pushes that will follow, POLITICO Pro is indispensable to those who need to make informed decisions fast. The Pro platform dives deeper into critical and quickly evolving sectors and industries, like healthcare, equipping policymakers and those who shape legislation and regulation with essential news and intelligence from the world’s best politics and policy journalists.
Our newsroom is deeper, more experienced and better sourced than any other. Our healthcare reporting team—including Alice Miranda Ollstein, Megan Messerly and Robert King—is embedded with the market-moving legislative committees and agencies in Washington and across states, delivering unparalleled coverage of health policy and the healthcare industry. We bring subscribers inside the conversations that determine policy outcomes and the future of industries, providing insight that cannot be found anywhere else. Get the premier news and policy intelligence service, SUBSCRIBE TO POLITICO PRO TODAY. | | | | | FIRST IN PULSE: SENATE DEMS UNVEIL IVF PACKAGE — Senate Democrats will introduce a package of bills today to preserve and expand access to assisted reproductive technologies, including in vitro fertilization, Alice reports. Democrats have seized on the issue in the wake of an Alabama court ruling granting legal personhood rights to frozen embryos. The bills, led by Sens. Tammy Duckworth (D-Ill.), Patty Murray (D-Wash.) and Cory Booker (D-N.J.), would establish a federal statutory right for individuals to access IVF that would override any future state attempts to impose restrictions. It would also enshrine access to the procedure for servicemembers and veterans and mandate public and private coverage. Duckworth, a disabled veteran who conceived two children through IVF, has long pushed to protect the procedure. Republicans blocked attempts to call her legislation up for a vote in 2022 and again in February, arguing it went too far. This new package comes on the heels of a GOP bill introduced by Sens. Ted Cruz (R-Texas) and Katie Britt (R-Ala.) that would strip Medicaid funding from states that “ban” IVF but allow for restrictions in the name of “health and safety.” Medical and patient advocacy groups have been critical of the Cruz/Britt version, with the American Society for Reproductive Medicine saying it would “only punish vulnerable patients and do little to protect fertility care.” The path forward: It’s unclear when — or if — either bill will receive a floor vote this year. BIRTH CONTROL VOTE — Senate Majority Leader Chuck Schumer is teeing up a vote on legislation aimed at safeguarding access to contraception. The Senate vote won’t be the end of Democrats’ efforts to put reproductive rights front and center. Schumer said Sunday that there’s “more action to come.” “Democrats will never relent until we reverse the immense damage MAGA Republicans and the Supreme Court have inflicted,” Schumer wrote in a “Dear Colleague” letter. The bigger picture: Reproductive freedom has emerged as a crucial electoral issue as the country nears the second anniversary of the Supreme Court’s Dobbs decision overturning the right to abortion. Former President Donald Trump said he was “looking at” contraception restrictions before walking that statement back, while President Joe Biden has made protecting access to care a key point of emphasis for his campaign.
| | | | A message from the American Health Care Association:   | | | | | HHS CHANGES COURSE ON CHANGE — After hundreds of providers lobbied the agency, HHS has said providers affected by a ransomware attack at Change Healthcare can delegate the task of notifying impacted patients to the medical billing giant. The clarification comes as a significant relief to hospitals, physician groups and private practices that saw patient records exposed amid the February cyberattack, POLITICO’s John Sakellariadis reports. As many as a third of Americans had their data stolen, according to Andrew Witty, CEO of UnitedHealth Group, Change's parent company. The details: HHS' Office for Civil Rights said Friday it updated its website to “make clear that” covered healthcare entities affected by the hack can contact Change and direct it to provide the notifications on their behalf. The providers wouldn’t be subject to any additional requirements under HIPAA, OCR said in a press release. UnitedHealth Group spokesperson Tyler Mason said the insurer welcomed the move. FIRST IN PULSE: PARITY PUSHBACK — A coalition of powerful groups is pushing back against the Biden administration’s proposal to require insurers to provide mental health care on the same terms as other care. The ERISA Industry Committee, Partnership for Employer-Sponsored Coverage and Chamber of Commerce, among others, wrote to the administration arguing the proposal would be “unworkable” and undermine access to care. The pushback adds to the criticism of the rule, as insurers have also slammed the proposal, saying workforce shortages are the main driver of barriers to care. The Biden administration's proposal includes fines for not closing loopholes the administration says they’re using to limit what they pay for mental health care. It’s not clear when it will be finalized. The push comes amid a growing mental health crisis.
| | | | JOIN US ON 6/13 FOR A TALK ON THE FUTURE OF HEALTH CARE: As Congress and the White House work to strengthen health care affordability and access, innovative technologies and treatments are increasingly important for patient health and lower costs. What barriers are appearing as new tech emerges? Is the Medicare payment process keeping up with new technologies and procedures? Join us on June 13 as POLITICO convenes a panel of lawmakers, officials and experts to discuss what policy solutions could expand access to innovative therapies and tech. REGISTER HERE. | | | | | | | | | POLITICO's Caitlin Emma reports on Congress bracing for a 2025 fiscal pileup. The Congressional Budget Office reports that climate change's impact on federal health care spending is “uncertain.” POLITICO’s Rory O’Neill reports on WHO negotiators agreeing to extend negotiations.
| | | | A message from the American Health Care Association: America’s seniors need our help – now.
The Administration’s federal staffing mandate will worsen the ongoing labor crisis in nursing homes, forcing more facilities to downsize or close.
Hundreds of thousands of residents will be displaced – and seniors’ access to care restricted – if lawmakers fail to act.
An unfunded mandate won’t create more caregivers. Congress: Protect seniors’ access to care – before it’s too late.
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